Directors of MD-PhD programs are aware of the situation & will be active in opposing changes that would be harmful of MD-PhD students. The directors were instrumental in blocking the ill-conceived attempt to change the USMLE structure a couple of years ago. The process is on-going, and we expect that there will eventually be some changes to the structure. There will undoubtedly have to be some compromises, but that is the nature of negotiation. My advice is that you not worry about it until it is time to worry about it.